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This chapter focuses on the rise of attention deficit–­ hyperactivity disorder (ADHD) as a childhood behavioral disorder in Argentina. In this country, diverse health and education professionals (with diverse theoretical and therapeutic positions) are intensely debating issues regarding the diagnosis and treatment of this condition. The Argentine case is of par­tic­u­lar interest owing to, among other ­factors, the coexistence of psychoanalytical and biological psychiatric approaches in the practices of health professionals and the cultural and po­ liti­ cal influence of psychoanalysis in the country. The current conflict in approaches to the diagnosis and treatment of ADHD is between the more psychoanalytical approach and the more biology-­and psychiatry-­ oriented one. Psychoanalysis-­ related professional groups are resistant to what they call tendencies ­ toward the medicalization and pathologization of ­ children. Psychoanalysts postulate that the iatrogenic effect provoked by stimulants and the use of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of ­ Mental Disorders (DSM) for diagnosing­ mental pathologies in ­ children violate the Ley Nacional de Salud ­ Mental 26.657 and the UN Convention on the Rights of the Child, which Argentina ratified and­ adopted through the Convención sobre los derechos de niños (Ley 23.849) in the 1990s. 9 The Journey of ADHD in Argentina From the Increase in Methylphenidate Use to Tensions among Health Professionals Silvia A. Faraone Eugenia Bianchi The Journey of ADHD in Argentina   163 The Ley Nacional de Salud ­ Mental, which was passed by Congress in 2010, empowered professional groups that stand against the pathologization of childhood ­ because it devoted central attention to the concept of ­ mental suffering; in­ doing so, it confronted medical-­ pharmaceutical hegemony. The UN Convention on the Rights of the Child (­ adopted by the General Assembly of the United Nations and ratified by Argentina in 1990) led to the inclusion of ­ these rights in the Argentine Constitution, which guaranteed ­ children the right to receive health-­ related assistance and to be kept safe and sound, protected from cruelty, negligence , and injustice.1 To explore the conflicting approaches to the diagnosis and treatment of ADHD in ­ children in Argentina, we pres­ ent the results of three studies carried out by the authors between 2007 and 2012. We include data from national and international specialized lit­ er­ a­ ture and newspaper articles. We also evaluate statistical data from the Confederación Farmacéutica Argentina (or COFA, a professional association of colleges) and the Administración Nacional de Medicamentos , Alimentos y Tecnología Médica (or ANMAT, the national agency that regulates, certifies, and monitors drugs, foods, and medical devices). In addition, we include data from 63 in-­ depth individual interviews and 2 in-­ depth group interviews with health professionals. Some further interviews ­ were carried out with key in­ for­ mants such as renowned child psychiatrists and pediatricians, chief pharmacists, and phar­ ma­ ceu­ ti­ cal sales representatives. In addition, scientific and academic publications on ADHD from Argentine authors ­ were analyzed, along with psychiatric manuals used to assist in diagnosis and treatment. ­ These manuals ­ were chosen ­ because of their widespread use in Argentina and the frequency with which professionals referred to them. Drawing on this nationwide research, this chapter provides information on the increasing sales of methylphenidate since the 1990s and, more recently, the growing distribution of ­ these sales in the country. We also describe the ways in which the conflicting views and tensions among professionals have influenced diagnostic and therapeutic decisions. ­ These decisions are intertwined with­ children’s-­ rights perspectives, state-­ orientated demands, and professionals’ critical views on their own practices. Even though it is not pos­ si­ ble to delineate a single map of the alignment of the vari­ ous disciplines and organ­ izations, this chapter anticipates some ­ future areas of conflict and re­ sis­ tance. 164   Global Perspectives on ADHD Medicalization and Biomedicalization According to the canonical definition, “medicalization” is the pro­ cess by which previously nonmedical prob­ lems become defined and treated as medical prob­ lems (Conrad 2013: 196). ­ Today, medicalization is characterized by issues that go beyond ­ those of the pioneering studies a half ­ century ago that dealt with the influence of doctors and law reformers as well as medical and scientific discoveries . Studies carried out during the 1970s from a medicalization perspective identified physicians, social movements, and interest groups, as well as orga­ nizational or inter-­ professional activities, as the core forces of ­ these pro­ cesses. Since then, medicine has under­ gone significant changes through which other forces have come to contribute substantially to...


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